Govt refuses to give NORI Certificate to doctors going abroad

Government justifies the stance of not issuing No Obligation to Return to India Certificate to outgoing doctors by highlighting the acute shortage of medical professionals in the country

Aurangabad :Maintaining its stand on not granting No obligation to return to India ( NORI) Certificate to doctors willing to go abroad, Government of India submitted its reply to the Aurangabad Bench of the Bombay High Court yesterday. The Government of India has justified the said move on the primary Public Health interest of the citizens of India on account of severe shortage of doctors in the country.

"Government of India cannot be expected to facilitate the wish of doctors from India to permanently settle abroad, by certifying that, their services are not required by the country, when the position is otherwise and the country is grappling with severe shortage of doctors."

The reply, which was submitted  by the Under Secretary, Ministry of Health and Family welfare on behalf of the Government Of India contained arguments on the following lines

SHORTAGE OF DOCTORS IN THE COUNTRY

• There is only one doctor per 1700 citizens in India, whereas the WHO stipulates a minimum ratio of 1: 1000


• As per March 2015, there were 420 medical colleges in the country, 200 in government and 220 in private sector, with 55,838 undergraduate seats ( govt 27,143, PVT 26,695) and more than 25000 post graduate seats. There are about 6.90 Lakh doctors in the country. However, India needs 4 Lakh more doctors by 2022 to achieve the required ratio of one doctor per 1000 people.


• A large number of posts including specialists, surgeons, obstetricians and gynecologists, physicians and pediatricians in the government PHC, CHC and District hospitals are lying vacant.


•  Currently, the out-migration of the medical professionals is in alarming state. More than 50,000 Indian doctors are serving in US, 30% of doctors in UK and 25% in Canada are of Indian Origin.

The government highlighted its efforts to tackle the shortage of medical professionals of which, the decision of not issuing NORI to doctors going abroad was a part.

NO HINDRANCE TO CAPACITY BUILDING OF DOCTORS

The Union of India highlighted that it facilitates medical doctors/ students joining training programmes/courses in medical specialties in medical institutions out of India (especially in USA), through the issue of Statement of Need (SON) certificates or Exceptional Need Certificates (ENC), whereby the Government of India allows doctors to study/train abroad, yet certifies that the home country is in need of doctors requiring admission abroad to the medical courses/training covered in such certificates.

These certificates are issued under the Exchange Visitor Programme of the Government of the USA (J-1 visa), in order to enable study/training of Indian medical student abroad. At the time of seeking SON certificate the applicant is required to furnish a written assurance that after completion of the said training/course he/she will return to the home country and enter the practice in the specialty for which SON certificate is being sought. This fact is also recorded in the SON certificate.

However, with certain exchange programs, there is requirement of NORI ( No obligation to Return to India), a requirement of the US government ( NOT of GOI), which requires the home country, to certify that the applicant is under no obligation to return to India. As a conscious policy decision, the ministry has decided not to issue NORI certificates, since issuing of the same amounts to admission by GOI that the services of the concerned applicants are not required, which goes against the policy of the government to encourage doctors studying abroad to come back and practice in India, in view of the prevalent shortage of doctors in the country.

Hence the Government maintained its stand of not issuing NORI certificates to doctors willing to go abroad.

NORI  IS NOT UNCONSTITUTIONAL

The petitioner, Central Maharashtra Association of Resident Doctors had stressed that the non-issuance of NORI certificate violated the fundamental rights of doctors under the Constitution of India. The GOI in its reply stressed that it is not violative, while highlighting that it is in public interest in view of shortage of doctors in the country.

What happens Next?

Based on the reply, the Petitioner Maharashtra Association of Resident Doctors is now going to file a rebuttal with the court. Citing flawed arguments given by GOI, Dr Sagar Munada, President MARD told Medical Dialogues, " During the year 2010-2014, total number of certificates issued by government were 3947. The government's argument seems flawed as stopping 4000 doctors from going abroad to tackle manpower shortage of 4 lakh, is like saving one drop from the ocean. Moreover, Government's decision not to issue NORI certificate to doctors would have been a good move, if and only if it was applied to all professions uniformly and singularly not just to doctors. MARD strongly opposes the reply by Union of India and will fight for our basic constitutional rights in the strongest possible manner. "

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